背景:肥胖是全球关注的健康问题和心血管疾病的危险因素。中心血压(cBP)的评估已被证明可以改善心血管事件的预测。然而,很少有研究调查肥胖对成人cBP的影响,缺乏关于这个问题的侵入性数据。这项研究旨在评估有肥胖和无肥胖患者之间的cBP差异,确定CBP决定因素,并评估Antares算法用于非侵入性cBP估计的准确性。
方法:共纳入190例接受选择性心导管检查的患者(25%为女性;39%为BMI≥30kg/m2;年龄:67±12岁)。使用带有集成Antares算法的custoscreen400设备,对cBP进行有创测量,同时进行无创估计。
结果:在肥胖和非肥胖患者之间没有发现显著的cBP差异。然而,女性,尤其是那些肥胖的人,收缩期cBP高于男性(P<0.05)。多元回归分析显示肱动脉平均压,脉压,BMI,和心率预测cBP显著(调整后的R2=0.82,P<0.001)。估计的cBP与收缩压的侵入性cBP密切相关,平均动脉,和舒张cBP(r=0.74-0.93,P<0.001),并显示出出色的准确性(平均差<5和SD<8mmHg)。
结论:这项研究发现肥胖和非肥胖患者的cBP没有显著差异。然而,它揭示了女性更高的cBP值,尤其是那些肥胖的人,这需要进一步调查。此外,该研究强调了Antares在非侵入性测定肥胖个体cBP中的有效性。这可以改善该特殊患者人群中高血压的诊断和治疗。
BACKGROUND: Obesity is a global health concern and risk factor for cardiovascular disease. The assessment of central blood pressure (cBP) has been shown to improve prediction of cardiovascular events. However, few studies have investigated the impact of obesity on cBP in adults, and invasive data on this issue are lacking. This study aimed to evaluate cBP differences between patients with and without obesity, identify cBP determinants, and evaluate the accuracy of the algorithm Antares for non-invasive cBP estimation.
METHODS: A total of 190 patients (25% female; 39% with BMI ≥30kg/m2; age: 67±12 years) undergoing elective cardiac catheterization were included. cBP was measured invasively and simultaneously estimated non-invasively using the custo screen 400 device with integrated Antares algorithm.
RESULTS: No significant cBP differences were found between obese and non-obese patients. However, females, especially those with obesity, had higher systolic cBP compared to males (P<0.05). Multiple regression analysis showed that brachial mean arterial pressure, pulse pressure, BMI, and heart rate predicted cBP significantly (adjusted R2 = 0.82, P<0.001). Estimated cBP correlated strongly with invasive cBP for systolic, mean arterial, and diastolic cBP (r = 0.74-0.93, P<0.001) and demonstrated excellent accuracy (mean difference <5 and SD <8 mmHg).
CONCLUSIONS: This study discovered no significant difference in cBP between obese and non-obese patients. However, it revealed higher cBP values in women, especially those with obesity, which requires further investigation. Additionally, the study highlights Antares\' effectiveness in non-invasively determining cBP in obese individuals. This could improve the diagnosis and treatment of hypertension in this special patient population.